Provider Demographics
NPI:1083867428
Name:HELM, SUSAN ANNE (LMP)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:ANNE
Last Name:HELM
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 LAKE HEIGHTS DR APT M304
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-6061
Mailing Address - Country:US
Mailing Address - Phone:425-232-3465
Mailing Address - Fax:
Practice Address - Street 1:2020 LAKE HEIGHTS DR APT M304
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-6061
Practice Address - Country:US
Practice Address - Phone:425-232-3465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA6044869174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist